This is a 371 of PCT/FR99/00454 filed Mar. 2, 1999.
The invention relates to the field of tubular compressive orthoses made of a knitted elastic textile material, i.e. of the xe2x80x9celasticated stockingxe2x80x9d type.
In the meaning of the present invention, such orthoses can have various shapes. For example, compressive orthoses for one or both lower limbs can be in the form of a stocking proper (covering the thigh and the calf), of tights (covering both lower limbs and the abdomen up to the waist, in a single piece), one-legged tights (tights provided with one leg only, for applying compression to only one of the lower limbs), or indeed socks (covering only the calf).
The invention also applies to compressive orthoses for the upper limbs.
The invention is therefore not limited to a particular article, but relates to all kinds of tubular compressive orthosis (i.e. excluding bandages) such as those described above.
To enable high compression to be applied to the limb(s), such orthoses are made of an elastic material, typically a knit of very tight texture, thereby giving rise to various difficulties.
In particular with orthoses of the stocking or tights type, one of the difficulties lies in putting it on over the foot and the ankle (where the orthosis is most difficult to put on and where compression at its strongest), with the risk of the orthosis being badly placed, particularly at the instep and the heel, which are zones where it is always rather difficult to put on an orthosis, particularly with increasing orthosis pressure.
This difficulty in putting on an orthosis is generally made worse by the fact that such orthoses are prescribed for treating circulatory diseases which often affect patients who are elderly, clumsy, sometimes suffering from a motor handicap, and suffering from arthritic phenomena that deform the hands and the feet, etc., i.e. people whose mobility is generally rather limited.
Furthermore, with post-surgical indications, after vein surgery, an orthosis can be made more difficult to put on by the dressings present on the leg after surgery, which dressings are often of the xe2x80x9cAmerican dressingxe2x80x9d type, i.e. very absorbent and therefore very thick, thus getting in the way of putting on an orthosis even though it is essential to avoid moving them. An orthosis can also be difficult to put on because the patient being under general anesthetic, so the patient cannot contract muscles voluntarily to provide active resistance while the orthosis is being put on; under such circumstances, it is important to avoid forcing the passive joints of the patient.
This difficulty in putting on compressive orthoses is an obstacle that is known both to patients and to carers, and numerous types of device have been proposed for making it easier, generally when the orthosis is a stocking, and most such devices comprise metal and/or rigid structures that are complex to operate.
FR-A-2 340 708 describes one such device, in the form of a rigid Turkish slipper cut open at the toes; that accessory does indeed make it easier to pass the stocking over the foot, but it provides no help of any kind with putting it on over the remainder of the limb, which operation remains very difficult when the limb carries dressings and the patient is immobilized under anesthetic.
An object of the invention is to propose a method and apparatus that are simple to use for putting an orthosis of the above-specified type onto a limb.
It will also be seen that the putting-on device of the invention is not expensive to make, which means that a discardable device can be provided for single use only, which is particularly advantageous for use with orthoses that are for treatment of a venous ulcer, since the device which might into contact with the wounds and the serosities could be a vector for germs if it were to be used with other patients. It will also be seen that in this particular indication, the single-use device can be integrated in the orthosis so as to make it easier to put on, and be detachable therefrom subsequently, thus enabling a carer to use a one-piece product that is suitable for putting on directly, and whose element that serves for putting-on purposes only can be separated and discarded after use.
More precisely, the method of the invention is characterized by the following steps: a) the limb is enveloped, over a length corresponding at least to the length of the orthosis, in a flexible sleeve of a material that presents a low coefficient of friction and high strength in traction and against tearing; b) the orthosis is put on over that portion of the limb which is enveloped by the sleeve, with this being performed manually, causing the orthosis to slide over its entire length on the sleeve interposed between the orthosis and the limb; and c) once the orthosis has been put on and put into place, the interposed sleeve is extracted by traction, the sleeve sliding between the orthosis and the limb which then come mutually into contact as the sleeve is extracted.
If the orthosis is open at both its distal and its proximal ends, then the sleeve is extracted via the distal opening by being pulled outwards in the region of this opening. If the orthosis is closed at its distal end and open at its proximal end, then the sleeve is extracted via the proximal end by being pulled outwards through said opening, and it is then withdrawn by passing the sleeve as extracted in this way around the limb, over the orthosis.
The invention also provides a device for implementing the method, the device being characterized by a flexible sleeve of material that presents a low coefficient of friction and high traction strength, and dimensioned in such a manner as to enable the limb to be enveloped over a length that corresponds at least to the length of the orthosis.
The flexible sleeve can be made of cloth, in particular a cloth that is coated in a material having a low coefficient of friction. It is advantageously tubular and open at at least one of its ends. It may optionally comprise two thicknesses of material turned inside out, one on the other, by invagination.
In a particular embodiment that is particularly adapted to single use, one of the ends of the sleeve is secured to the distal end of the orthosis via a separable link.
To make the sleeve easier to extract, it can be provided at one of its ends with at least one reinforcing element forming a strap or a handle for taking hold of and pulling.